Automatic suture fixation apparatus and method for minimally invasive cardiac surgery

Abstract

A method for automatically fixing sutures to secure a valve sleeve including an annular cuff and a replacement heart valve to an annulus formed in a patient's heart, includes the steps of removing an existing heart valve thereby forming an annulus in the patient's heart, and placing a first cylinder having a first end and a second end and an interior surface and an exterior surface and comprising first securing means formed on the exterior surface adjacent to the second end of the first cylinder, in which the first cylinder includes a valve sleeve having an annular cuff, such that the annular cuff surrounds the exterior surface adjacent to the first end of the first cylinder. Moreover, the method includes creating a blood-tight seal between the cuff of the valve sleeve and the annulus, and securing the plurality of sutures between the first cylinder and the second cylinder.

1. A method for automatically fixing sutures to secure a valve sleeve including an annular cuff and a replacement heart valve to an annulus formed in a patient's heart, comprising the steps of:
 removing an existing heart valve thereby forming an annulus in the patient's heart; 
 placing a first cylinder having a first end and a second end and an interior surface and an exterior surface and comprising first securing means formed on said exterior surface adjacent to said second end of said first cylinder, wherein said first cylinder includes a valve sleeve having an annular cuff, such that said annular cuff surrounds said exterior surface adjacent to said first end of said first cylinder; 
 positioning said annular cuff of said valve sleeve in said annulus and securing said cuff to said annulus with a plurality of sutures; 
 threading said plurality of sutures over said exterior surface of said first cylinder and over an interior surface of a second cylinder, said second cylinder having second securing means corresponding to and adapted to fixedly engage said first securing means of said first cylinder; 
 creating a blood-tight seal between said cuff of said valve sleeve and said annulus; and 
 securing said plurality of sutures between said first cylinder and said second cylinder by engaging said first securing means of said first cylinder with said second securing means of said second cylinder. 
 
   
   
     2. The method of  claim 1 , further comprising the step of trimming said plurality of sutures at a length in a range of about 3 mm to about 5 mm, above said second cylinder. 
   
   
     3. The method of  claim 1 , further comprising the step of trimming said plurality of sutures flush with said second cylinder. 
   
   
     4. The method of  claim 1 , wherein said plurality of sutures is in a range of about 18 to 24 sutures. 
   
   
     5. A method for automatically fixing sutures to secure a valve sleeve including an annular cuff and a replacement heart valve to an annulus formed in a patient's heart, comprising the steps of:
 removing an existing heart valve thereby forming an annulus in the patient's heart; 
 placing a first cylinder having a first end and a second end and an interior surface and an exterior surface and comprising first securing means formed on said exterior surface adjacent to said second end of said first cylinder, wherein said first cylinder includes a valve sleeve having an annular cuff, such that said annular cuff surrounds said exterior surface adjacent to said first end of said first cylinder; 
 positioning said annular cuff of said valve sleeve in said annulus and securing said cuff to said annulus with a plurality of sutures; 
 threading said plurality of sutures over said exterior surface of said first cylinder and over an interior surface of a second cylinder, said second cylinder having second securing means corresponding to and adapted to fixedly engage said first securing means of said first cylinder; 
 creating a blood-tight seal between said cuff of said valve sleeve and said annulus; 
 securing said plurality of sutures between said first cylinder and said second cylinder by engaging said first securing means of said first cylinder with said second securing means of said second cylinder 
 positioning a guiding rod including a rod end piece formed at a first end of said rod, said rod end piece having a plurality of support brackets extending from said rod end piece and a guiding ring affixed to said support brackets, wherein said ring is adapted to engage a second end of said first cylinder, to engage said first cylinder and to hold said cuff against said annulus; 
 positioning said second cylinder, such that said interior surface of said second cylinder slidingly engages an exterior surface of each of said support brackets of said guiding rod; 
 positioning a securing member which slidingly engages said guiding rod, and has a rod sleeve end piece formed on a first end of said rod sleeve, said sleeve end piece having a plurality of securing brackets, which are adapted to engage said second cylinder and which are positioned to interfit with said support brackets, such that said securing member engages said second cylinder; 
 threading said plurality of sutures through a plurality of eyelets formed on said plurality of securing brackets; and 
 urging said securing member on said guiding rod, whereby said second securing means of said second cylinder is urged into engagement with said first securing means on said first cylinder. 
 
   
   
     6. A method for automatically fixing sutures to secure a valve sleeve including an annular cuff and a replacement heart valve to an annulus formed in a patient's heart, comprising the steps of:
 removing an existing heart valve thereby forming an annulus in the patient's heart; 
 positioning said annular cuff of said valve sleeve in said annulus and securing said cuff to said annulus with a plurality of sutures; 
 placing a first cylinder having a first end and a second end and an interior surface and an exterior surface and comprising first securing means formed on said exterior surface adjacent to said second end of said first cylinder, within said valve sleeve, such that said annular cuff surrounds said exterior surface adjacent to said first end of said first cylinder; 
 threading said plurality of sutures over said exterior surface of said first cylinder and over an interior surface of a second cylinder, said second cylinder having second securing means corresponding to and adapted to fixedly engage said first securing means of said first cylinder; 
 creating a blood-tight seal between said cuff of said valve sleeve and said annulus; and 
 securing said plurality of sutures between said first cylinder and said second cylinder by engaging said first securing means of said first cylinder with said second securing means of said second cylinder. 
 
   
   
     7. The method of  claim 6 , further comprising the step of trimming said plurality of sutures at a length in a range of about 3 mm to about 5 mm, above said second cylinder. 
   
   
     8. The method of  claim 6 , further comprising the step of trimming said plurality of sutures flush with said second cylinder. 
   
   
     9. The method of  claim 6 , wherein said plurality of sutures is in a range of about 18 to 24 sutures. 
   
   
     10. The method of  claim 6 , further comprising the steps of:
 positioning a guiding rod including a rod end piece formed at a first end of said rod, said rod end piece having a plurality of support brackets extending from said rod end piece and a guiding ring affixed to said support brackets, wherein said ring is adapted to engage a second end of said first cylinder, to engage said first cylinder and to hold said cuff against said annulus; 
 positioning said second cylinder, such that said interior surface of said second cylinder slidingly engages an exterior surface of each of said support brackets of said guiding rod; 
 positioning a securing member which slidingly engages said guiding rod, and has a rod sleeve end piece formed on a first end of said rod sleeve, said sleeve end piece having a plurality of securing brackets, which are adapted to engage said second cylinder and which are positioned to interfit with said support brackets, such that said securing member engages said second cylinder; 
 threading said plurality of sutures through a plurality of eyelets formed on said plurality of securing brackets; and 
 urging said securing member on said guiding rod, whereby said second securing means of said second cylinder is urged into engagement with said first securing means on said first cylinder. 
 
   
   
     11. The method of  claim 1 , wherein said step of creating a blood tight seal further comprises applying pressure against said first cylinder and tension to said plurality of sutures. 
   
   
     12. The method of  claim 6 , wherein said step of creating a blood tight seal further comprises applying pressure against said first cylinder and tension to said plurality of sutures.